NPIMap

Individual provider Active NPI

Li Sheng Kong, M.D.

  • Vascular Surgery Physician
  • Ventura, CA
National Provider Identifier
1891764775
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A99886 Issued in CA
Practice address
100 N Brent St
Suite 201
Ventura, CA 93003-2822
Phone
(805) 663-3330
Fax
(805) 663-3331
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101238893 VA
Vascular Surgery Physician 2086S0129X A99886 CA Primary

Addresses

Primary practice location

100 N Brent St
Suite 201
Ventura, CA 93003-2822

Mailing address

100 N Brent St
Suite 201
Ventura, CA 93003-2822
Phone (805) 663-3330

Other identifiers 7

IdentifierTypeStateIssuer
010242452MedicaidVI
010251877MedicaidVA
010242517MedicaidVA
010252695MedicaidVA
010242487MedicaidVA
010242424MedicaidVA
010242479MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828000889 CA Practitioner - Vascular SurgeryPractitioner - General Surgery 0244252773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Tennessee, HSC, College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Cardiovascular and Vein Institute IncGroup PAC ID 6709256696, 5 clinicians

Practice addresses (Care Compare)

2000 Outlet Ctr Dr
Suite 225
Oxnard, CA 93036-0605
Phone (805) 643-3330

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.1 of 100Reported as group
Quality
88.11
Promoting interoperability
97
Improvement activities
40
Cost
63.41

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal12
Leg revascularization (restoring blood flow)104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A99886CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Cardiovascular and Vein Institute, Inc. Vascular Surgery CurrentSince Feb 1, 2023 Accepting new patients
Central Coast Cardiovascular ASC LLC Past Accepting new patients
Community Memorial Health System Past Accepting new patients
Inova Health Care Services Past Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

3901 Las Posas Rd
Ste 17
Camarillo, CA 93010
Phone (805) 388-2068

2000 Outlet Center Dr
Ste 225
Oxnard, CA 93036
Phone (805) 444-4491

100 N Brent St
Ste 201
Ventura, CA 93003
Phone (805) 620-3499

100 N Brent St
Ste 2
Ventura, CA 93003

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lishengkong@wcv.allscriptsdirect.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1891764775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BRENT ST",
            "address_2": "SUITE 201",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032822",
            "telephone_number": "805-663-3330",
            "fax_number": "805-663-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BRENT ST",
            "address_2": "SUITE 201",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032822",
            "telephone_number": "805-663-3330",
            "fax_number": "805-663-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "LI SHENG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101238893",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A99886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010242452",
            "state": "VI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010251877",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010242517",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010252695",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010242487",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010242424",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010242479",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.